Active NPI
Tri-State Ambulance, Inc.
- Land Ambulance
- La Crosse, WI
National Provider Identifier
1659402600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 6011353
- Legal business name
- TRI-STATE AMBULANCE, INC.
- Practice address
- 235 Causeway Blvd
La Crosse, WI 54603-3119 - Phone
- (608) 782-2282
- Fax
- (608) 782-4522
- NPI assigned
- Mar 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tom Tornstrom
- Title
- Director
- Phone
- (608) 782-2282
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 6011353 | WI | Primary |
Addresses
Primary practice location
235 Causeway Blvd
La Crosse, WI 54603-3119
Mailing address
235 Causeway Blvd
La Crosse, WI 54603-3119
Phone (608) 782-2282
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0554113 | Medicaid | IA | |
| 41359100 | Medicaid | WI | |
| 263067200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090113000224 | WI | Part B Supplier - Ambulance Service Supplier | 5698838951 | Practice locations: Holmen, WI; La Crosse, WI; Viroqua, WI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0931184 | Tri-State Ambulance Inc | Certificate of waiver | Jul 23, 2027 |
| 52D2032715 | Tri-State Regional Ambulance | Certificate of waiver | Nov 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
221 Buchner Pl
La Crosse, WI 54603
2827 26th St S
La Crosse, WI 54601
Phone (608) 788-2322
110 Brendal Ln
#A
Viroqua, WI 54665
Phone (608) 637-8639
126 W Jefferson St
Viroqua, WI 54665
Phone (608) 637-8639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745366400000",
"number": "1659402600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 CAUSEWAY BLVD",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546033119",
"telephone_number": "608-782-2282",
"fax_number": "608-782-4522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 CAUSEWAY BLVD",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546033119",
"telephone_number": "608-782-2282",
"fax_number": "608-782-4522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI-STATE AMBULANCE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-08",
"last_updated": "2025-04-23",
"certification_date": "2025-04-23",
"status": "A",
"authorized_official_last_name": "TORNSTROM",
"authorized_official_first_name": "TOM",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "608-782-2282"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "WI",
"license": "6011353",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0554113",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41359100",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "263067200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.